You readers have been especially prolific lately. I've wanted to share your thoughts with everyone else for some time now, but I've been running off at the mouth myself so much lately with predictions for the new year and recaps of the one just past that I haven't had the space. But that all changes this week.
Allow me to thank you, belatedly. In the past 18 months, this e-newsletter has become an invaluable connection for me to many important and influential folks that I would otherwise never have met. That helps me keep my finger on the pulse of what's important to you, and also helps me improve my coverage in HealthLeaders magazine each month. So without further delay, here are some of the most interesting comments I've received in recent months.
On my snarky news commentary about a "monument to healthcare excess" that may soon rise in Manhattan, one person in particular was perturbed. I'll admit my shot was fired in haste, but I stand by it. I also take issue with NYC being the "world's leading healthcare hub," but it's clearly not something that can be proved or disproved. Since I can't link to my original commentary, I'll reprint it here. The response runs after. I'll let you all judge who has the bigger conflict of interest—the writer or myself.
Developers in Manhattan are pitching a 60-story glass-and-steel tower on the island's West Side as an international showcase and permanent conference center for the healthcare industry. Supporters envision the building as a permanent exhibition center for hundreds of vendors to the medical industry, from hospital food and furniture suppliers to pharmaceutical companies and makers of X-ray machines and surgical devices, according to the article. Call me a cynic, but as the article describes it, I envision the building as a permanent version of the nauseating temporary booths vendors try to outdo each other with at the big healthcare trade shows—most of which are simply expensive tributes to excess. Perhaps they could add some penthouse apartments to house those ubiquitous "booth babes?"
Dear Mr. Betbeze:
Your Dec. 1 item about the highly-anticipated World Product Centre now being developed in New York missed the mark.
The World Product Centre is a visionary project that will reshape global healthcare. The 60-story, 1.5 million-square-foot center will be the world's first permanent international healthcare marketplace and education center. It will bring the most innovative medical devices, diagnostics, technology, pharmaceuticals, and healthcare services under a single roof. It will increase transparency in medical sales and lower healthcare costs worldwide.
Medical meetings and tradeshows are critical components of the international healthcare industry with more than 2,000 medical meetings and continuing medical education courses held in the United States each year. They should continue to operate as they currently do. The World Product Centre will complement these shows and meetings by adding a single location where a full array of medical products and services can be showcased on a year-round basis, and will provide a central meeting ground where technological synergies can take place.
New York already is the world's leading healthcare hub, so it is the logical location for a center of this kind. With close to 9 million international visitors to New York last year, it is the nation's No. 1 international destination, with more than 100 million passengers traveling though our airports.
The World Product Centre is scheduled to open in 2013. It will be a commanding addition to the global healthcare market.
Cristyne L. Nicholas, Former President and CEO of NYC & Company, the city's convention & visitors bureauThis one's a gem of a response to my Nov. 10 article on community benefit.
Dear Phil:
I think we can all agree that the original concept of the nonprofit community hospital run as a charitable cause by religious organizations has long since vanished. In its place are corporate businesses indistinguishable from their for-profit brothers and sisters (except for equity value).
Many nonprofit hospital/health systems report their "profits" in the media and talk about their "profitability." Ascension Health, the largest Catholic nonprofit, recently reported that it delivers charitable care valued at just over 2% of revenue. Fortune 500 corporations have records of giving that rival that. Of course, 2% is better than nothing, and this doesn't make them bad people. It does, however, further expose the nonprofit masquerade. Many hospital organizations operate the same as for-profit companies and should logically be converted to for-profit corporations. But it is a separate issue over whether these healthcare "corporations" should be subject to federal and state income taxes. A significant percentage of hospital revenue (indeed healthcare revenue) comes from state and federal government, which now accounts for more than $1 trillion in annual payments into the healthcare system.
It makes marginal sense for any hospital or healthcare provider to be subject to income taxes on profits derived from revenues received from government. The real issue Congress should be addressing is whether any healthcare player, profit or nonprofit, should be subject to income taxes at all. We have runaway healthcare costs with government the largest single payer and seeking to play a greater role by establishing universal healthcare. Wouldn't it make more sense to suspend income taxation on all healthcare facilities, possibly physician practices, and yes, even health insurers; for-profit or nonprofit? We know that taxation throughout the healthcare industry is as flawed as its financial incentives. Employers get deductions, but individuals do not; one hospital in town pays, the other does not; and on it goes.
Congress can relieve a degree of financial pressure in the industry just by changing how healthcare is taxed, which is within its power; rather than trying to distinguish whether a healthcare organization is operating for profit or not. The constant trading of dollars back and forth among healthcare providers, health insurers, and government is a waste of time and resources and does not give us the most healthcare for the dollar. I'll leave the issues of local property real estate taxes, charitable contributions, and equity value for another day. We should not have to have discussions over which organization provides the greater community benefit—and healthcare is different from Wal-Mart. The federal government isn't Wal-Mart's biggest customer.
Robert L. Trinka, Chairman & CEO PhyhealthFinally, here is a quick hit in support of my column Good Thing Hospitals are Closing. And by the way, I'll run a rebuttal column from a hospital CFO in my "Finance Forum," section in an upcoming issue, just in case you thought I was cherry-picking the responses that agreed with me.
Phil,
Excellent article and very refreshing to read the truth—if businesses can't make it, then they should be allowed to fail and fade away. New healthier businesses (healthcare delivery systems) will emerge from the ashes and we will be better off for it.
Patrick D. Barron, President and CEO Emergency Medical Care, LLC
Philip Betbeze is finance editor with HealthLeaders magazine. He can be reached at pbetbeze@healthleadersmedia.com.
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